AHCA and Three Scenarios: Repeal, Replace, Repair

Any similarities of the title of this blog and Goldilocks and the Three Bears belies the serious decisions needed for the next round of healthcare reform. Last month, PwC’s Health Research Institute (HRI) released another fantastic research piece that maps out three possible landing spots: repeal, replace, repair. Here are 10 instances which can help you better identify when its time to look for a partner.

HEDIS Success & Value Based Care

The Healthcare Effectiveness Data and Information Set (HEDIS) is a tool used by 90% of the United States’ Health Plans to measure performance on important elements of care and service. HEDIS standardizes the way health plans collect, analyze, and report data. It creates an equal playing field for all health plans (who use HEDIS) to be compared. It also can be used by employers, consultants, and patients to find the best health plan match for their needs. Many payers are now using value based reimbursement models to help meet HEDIS benchmarks. These value based programs make providers accountable for closing gaps in care and meeting HEDIS measures.

By | 2017-05-17T12:58:53+00:00 October 3rd, 2016|Health Insurance, Uncategorized|0 Comments

NCQA Releases Health Insurance Plan Ratings for 2016

On September 22, 2016 the NCQA announced the release of the 2016-2017 Health Insurance Plan Ratings, this is the second year of the NCQA's new rating methodology. The Health Insurance Plan Ratings. which are published annually and compare the quality and services of more than 1,000 health plans across the United States. One new aspect of the 2016-2017 ratings is that WebMD will be publishing the ratings on their WebMD.com.

By | 2017-04-02T13:28:01+00:00 September 29th, 2016|Health Insurance, Uncategorized|0 Comments

Understanding Value Based Reimbursement

The healthcare industry has undergone major changes since the rollout of the Affordable Care Act and now a new type of reimbursement model is putting traditional incentive based payment models on the shelf for good. Value based reimbursement, which ensures that providers are rewarded for performance, quality, and cost reduction (instead of number of services provided), is a model that will help shape the future of healthcare.

By | 2017-04-02T13:28:06+00:00 May 23rd, 2016|Financial, Financial Analysis, Health Care Reform, Health Insurance|Comments Off on Understanding Value Based Reimbursement

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